[Acute cardiorenal syndromes].

Area of Science:

• Cardiology
• Nephrology
• Critical Care Medicine

Background:

• The heart and kidneys are interdependent organs with significant crosstalk.
• This interaction involves humoral regulation and inflammatory mediators, similar to systemic inflammation.
• Impairment in one organ can lead to dysfunction in the other, termed cardiorenal syndrome (CRS).

Purpose of the Study:

• To summarize the common types of cardiorenal syndrome (CRS) encountered in emergency and intensive care settings.
• To outline diagnostic criteria and workup for CRS.
• To describe therapeutic strategies for managing CRS.

Main Methods:

• Review of existing literature on cardiorenal syndrome.
• Focus on CRS types 1 and 3, prevalent in acute care.
• Discussion of diagnostic tools including KDIGO criteria, echocardiography, ECG, cardiac enzymes, and BNP.
• Outline of treatment principles for CRS.

Main Results:

• Cardiorenal syndrome (CRS) is classified into 5 types, with types 1 and 3 being most common in critical care.
• CRS type 1 involves acute kidney injury secondary to acute heart failure.
• CRS type 3 involves acute cardiac failure secondary to acute kidney injury, often from nephrotoxins.

Conclusions:

• Diagnosis of CRS should utilize KDIGO criteria for AKI and cardiac assessments like echocardiography and BNP.
• Treatment for CRS prioritizes addressing the underlying organ dysfunction.
• Management of CRS type 3 includes optimizing kidney perfusion, careful fluid management, and avoiding nephrotoxins; renal replacement therapy may be needed for fluid overload.